[htrn]

This seems like a dumb question, but here it goes.

Had a patient that was given rogham after a d&c a few weeks ago. She presented to ER this weekend with heavy vaginal bleeding and positive pregnancy test. Also had cervical biopsy late last week. Pelvic exam revealved bleeding from the cervical os.

Pregnancy test could still be + from the lost pregnancy, or she could be in the very early stages of new pregnancy. Pt. states she had a negative home pregnancy test since the d&c. Confirmed vaginal bleeding from the cervix, heavier than a period. Recent Rogham administration (within last 4-6 weeks). Only 300mcg Rogham available at my facility.

We gave her the 300mcg Rogham prior to her discharge just to be safe.

What is the policy in your ER. BTW, small hospital - no OB's, only famiy practice docs that do deliveries. We only have about 80 deliveries a year hear.

[GrumpyRN63]

Rhogam needs to be given with each pregnancy, unless it is certain the FOB is Rh neg, so in other words, it doesn't "last" , it could be 4 weeks or 10 years, if it's a new pregnancy she needs a new shot, each fetus has the potential to be Rh incompatible, if those fetal cells get into the maternal circulation she can develop antibodies against future pregnancies with devastating results, hope that helps